Obamacare allies eye ballot initiatives

Local groups in some states say they’ve begun mobilizing for 2014. | Reuters

Ben Domenech, research fellow at the Heartland Institute, also said governors could have a rude awakening if they go the referenda route. “While Medicaid expansion may poll well in some states and I expect the providers to spend big bucks trying to get more taxpayer dollars flowing their way, that’s only because citizens have yet to learn the truth about the costs and defects of the expansion approach,” he said in an email. “Politicians may think in the short term of election cycles — citizens don’t.”

But that’s not how some of the advocates see it in their states. Ohio-based advocate John Begala, whose Center for Community Solutions first floated the notion of a ballot push in that state, said, “There is a very broad coalition of organizations supporting expansion of health care benefits under the Affordable Care Act in Ohio.”

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Talk of a Montana ballot initiative started swirling near the end of the legislative session, when Democrats failed by one vote — mistakenly cast by one of their own — to push through expansion legislation. Montana’s Legislature isn’t due back until 2015.

Montana state Sen. David Wanzenried, who led the failed legislative push, says he has “no doubt” expansion backers can round up support for the ballot initiative. And Stephanie Larsen of the Center for Rural Affairs said measures tend to pass in Montana once they get on the ballot.

But not all state advocates are ready to move on ballot efforts yet. Medicaid supporters in Tennessee, Louisiana and Oklahoma — all conservative states with strong opposition to the health law — say they just aren’t ready to take it to the voters.

In Arizona, Gov. Jan Brewer — another GOP supporter of expansion — said through spokesman Matthew Benson that a ballot measure shouldn’t be necessary. Brewer’s Medicaid plan passed the state Senate on Thursday, but it faces a tough battle in the House.

“Gov. Brewer believes legislators were elected to make the tough decisions, so she opposes punting the Medicaid question to the ballot,” Benson said.

But state House Speaker Andy Tobin has suggested that Republican leaders opposed to the expansion may take the issue to the voters — if only to break the stalemate that’s keeping the state lawmakers from getting much else done.

Pollack, of Families USA, said ballot measures might turn out to be moot. He expects more governors and legislatures will warm to expansion as the political calendar flips closer to 2014 and primary matchups materialize.

“There are a number of governors and state legislators who are silently inclined to move forward with the Medicaid expansion but won’t do so until it’s clearer who their primary opposition is going to be,” he said. “The major political concern that they have is that if they supported this now that that might make it more likely that they’ll have a far right-winger oppose them in the primaries.”